In Reply.—We thank Dr Doig for his comments and queries. Enrollment in this study was from November 4,1989, through December 19, 1990. Only 18 of the 20 centers entered patients, and some sites joined the study late in 1990. The mean±SD number of entries per site was 2.8±1.5 (range, 1 to 6). A systematic record was not maintained for the number of patients screened, the number eligible for enrollment, or any reasons for exclusion other than those stated under "Methods." Intermittent random evaluations at various centers did not identify any biases. Patient enrollment was limited by the strict enrollment criteria, in particular, entry within 18 hours of the onset of sepsis or sepsis syndrome (see "Methods"). Refusal was rare. Therefore, we believe the subjects entered into this study were representative of our general ICU populations.Doig appropriately notes that administration of Exosurf is usually evident in the endotracheal tube